Table 1.
Study characteristics of included studies
| Reference | Study design | Population | N | Age at onset (SD) in years | Age in study (SD) in years | AED use | Risk of Bias |
|---|---|---|---|---|---|---|---|
| Berg et al., 2011, 2014 | Prospective | CAE | 51–59 | ESM 5.9 (1.8); VPA 6.4 (1.8) | NA | ESM 69%, VPA 31% | Low |
| Caplan et al., 2008 | Case-control | CAE | 69 | 6.15 (2.52) | 9.64 (2.49) | No AED 12%, Monotherapy 76%- > VPA 51%, ESM 35%, Other 14%, Polytherapy 13% | Low |
| Cerminara et al., 2013 | Case-control | CAE | 24 | NA | NA | VPA 18, LEV 4, LTG 1, VPA + LTG 1 | Moderate |
| Cheng et al., 2017 | Case-control | CAE | 43 | ≤5: n = 14; >5 29 | 9.5 (2.6) | No AED 7%, Monotherapy 72%, Duotherapy 21% | Low |
| Conant et al., 2010 | Case-control | CAE | 16 | 4.5–8 | 8.0 (1.3) | No AED 6, VPA 10, VPA + ESM 1 | Low |
| Conde-Guzon & Cancho-Candela, 2012 | Case-control | AE | 34 | 5.1 (1.2) | 8.7 (1.26) | 100% VPA | Low |
| Covanis et al., 1992 | Retrospective | AE | 124 | 2.5–13.5 | NA | ‡ | Moderate |
| D’Agati et al., 2012 | Case-control | CAE | 15 | 8.8 (1.74) | 11.46 (2.23) | VPA 100% | Moderate |
| Fastenau et al., 2009 | Prospective | AE | 38 | 6–14 | NA | NA | Low |
| Franzoni et al., 2015 | Retrospective | AE drug-resistant | 92 | 5.33 | 3y minimal follow-up time | Polytherapy 100%, >3AED’s 47%, >5 AED’s 53% | Low |
| Gencpinar et al., 2016 | Case-control | CAE | 69 | 3–6; n = 14, ≥7 n = 5 | 12.22 (2.46) | Monotherapy 73.7%, Duotherapy 26.3%, Tripletherapy 26.3% | Moderate |
| Guerrini et al., 2015 | Case-Control | CAE | 82 | 6.28 (2.5) | 9.7 (1.78) | NA | Low |
| Henkin et al., 2003, 2005 | Case-control | AE | 12 | 7.2 | 14.4 (1.83) | VPA 100% | Moderate |
| Kernan et al., 2012 | Case-control | CAE | 31 | 6 (2) | 9 (2) | No AED 6%, Monotherapy 68%, Polytherapy 26% | Low |
| Levav et al., 2002 | Case-control | CAE | 28 | 5.6 (2–16) | 14.0 (10.5) | No AED 18, Monotherapy 7, Polytherapy 3 | Low |
| Lopes et al., 2013, 2014 | Case-control | CAE | 30 | 6.83 (2.32) | 9.93 (2.54) | No AED 13%, Monotherapy 73%, Duotherapy 13% | Low |
| Masur et al., 2013; Shinnar et al., 2017 | RCT | CAE | 446 |
≥6 years of age n = 336 <6 years of age n = 110 |
Pre-treatment analysis (=max. 1 week after start AED) |
After randomization: ESM 35%, LTM 33%, VPA 32% | Low |
| Mostafa et al., 2014 | Cross-sectional | CAE | 10 | 8.4 (1.9) | 13 (4.1) | VPA 80%, LTG 20% | Low |
| Nolan et al., 2004 | Prospective | CAE | 13 | 5.5 (2.0) | 9.5 (2.3) | Monotherapy 48%, Polytherapy 62% | Moderate |
| Oostrom et al., 2003 | Prospective | CAE or JAE | 10 | NA | 9.2 (1.9) | 100% AED not specified | Moderate |
| Pavone et al., 2001 | Case-control | AE | 16 | 5.3 | 9.2 (3) | ESM 2, VPA 11, ESM + VPA 3 | Low |
| Schraegle et al., 2016 | Cross-sectional | CAE | 30 | 4.83 (1.89) | 11.1 (2.95) | Monotherapy 16%, Polytherapy 46.7% | Low |
| Sinclair & Unwala, 2007 | Retrospective | AE | 80 | 7.5 (2.7) | 13.9 (3.2) | NA | Moderate |
| Siren et al., 2007 | Case-control | CAE 9, JAE 1 | 10 | 3.0–11.8 | 8.2, 5.5–14.5 | VPA 4, ESM 5, VPA+ESM 1 | Low |
| Urena-Hornos et al., 2004 | Retrospective | AE | 49 | 7.93 | 10 days-13 years follow up | Monotherapy VPA 78%‡ | Moderate |
| Vanasse et al., 2005 | Case-control | AE | 10 | 5.17 (2.26) | 10.13 (1.69) | Monotherapy 5, Polytherapy 5 | Moderate |
| Vega et al., 2010 | Case-control | CAE | 38 | 6.9 (2.8) | 10.5 (2.3) | No AED 13.2%, Monotherapy 63.2%, Duotherapy 21.1%Polytherapy 2.6% | Low |
| Verrotti et al., 2011 | Retrospective | AE before age of 3 | 40 | 2.2 (0.59) | 8.19 | No AED 2, VPA 26, LTG 1, LEV 1, ESM 3, VPA- > CLB 1, VPA->ESM 2, VPA- > LEV 1, VPA- > LTG 1, VPA->ESM 1, VPA- > CLB 1 | Low |
| Wirrell et al., 1996 | Retrospective | CAE | 60 | 5.7 (2.8) | 20.4 (4.2) | No AED 47, VPA 9, VPA + LTG 1, LTG 1 VPA+ESM 1, ESM + LTM + CBM 1 | Moderate |
a May contain overlapping patients, however reports on neuropsychological test results did not overlap ‡ Refer to original paper
AE, Absence Epilepsy; AED, Anti-Epileptic Drug; CAE, Childhood Absence Epilepsy; CBM, Carbamazepine; CLB, Clobazam; ESM, Ethosuximide; JAE, Juvenile Absence Epilepsy; LEV, Levetiracetam; LTG, Lamotrigine; N, number of patients; NA, Not available; RCT, Randomized Clinical Trial; SD, Standard Deviation; VPA, Valproic Acid